Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To exploit possible dose-response and combination drug synergism, 20 previously untreated patients with extensive-stage small-cell lung cancer (SCLC) received one or two courses of high-dose induction chemotherapy consisting of cyclophosphamide (100 mg/kg), etoposide (1,200 mg/m2), and cisplatin (120 mg/m2) (HDCEP). HDCEP was followed by four cycles of standard-dose cyclophosphamide (1,000 mg/m2), doxorubicin (40 mg/m2), and vincristine (1.4 mg/m2) (CAV). Response was determined after HDCEP and following CAV. Reevaluation included repeat bronchoscopy and chest computerized tomography (CT), as well as repetition of all initially abnormal studies. All patients were evaluable for response and toxicity. Overall response to HDCEP was 90%, with a complete response (CR) rate of 65% (95% confidence limits, 44% to 86%) and a partial response (PR) rate of 25% (95% confidence limits, 6% to 44%). All patients either maintained or improved their initial response while receiving CAV. Median duration of response was 6 months (range, 2 to 12 months) and median survival was 9.5 + months (range, 2 to 21 + months). All 37 courses of HDCEP were associated with leukopenia (less than 1,000/microL), 92% with thrombocytopenia (less than 20,000/microL), and 84% with fever of greater than 38.5 degrees C. Additional toxicities included bacteremia (24%), nausea and emesis (59%), mucositis (57%), diarrhea (38%), and hemorrhagic cystitis (5%). There were two treatment-related deaths due to infection. A third patient died 4 months after completing HDCEP with pulmonary fibrosis. Although response duration and median survival were not improved, HDCEP produced a high CR rate in ambulatory patients with extensive-stage SCLC.
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PMID:High-dose induction chemotherapy with cyclophosphamide, etoposide, and cisplatin for extensive-stage small-cell lung cancer. 303 61

In a previous study on the antiemetic effect of nabilone (N) in patients with lung cancer receiving chemotherapy (CT), we found that N was only moderately effective and that its side effects limited its use, especially in elderly outpatients. We, therefore, performed a new study of N in combination with dexamethasone (DXM), a potent antiemetic in itself, to evaluate whether the addition of DXM to N would improve the antiemetic effect and/or reduce the side effects. Forty patients with lung cancer were enrolled in the study. A randomized, third-party-blinded, crossover design was used. Study drugs were given during two consecutive, identical CT cycles. N was given at a fixed dosage regimen of 2 mg b.i.d. The initial dose was administered the evening before CT, the second dose at 0.5 h before CT, and the third dose in the evening 12 h after CT. DXM, 8 mg, or placebo was given orally with the first dose of N. The subsequent doses (either 10 mg DXM or saline) were given intravenously 0.5 h before CT and at 2 and 6 h after the start of CT. The CT regimens given included the following drugs in various combinations: cisplatin, cyclophosphamide, adriamycin, etoposide (VP-16), vincristine, and vindesine. The combination of N and DXM was significantly superior to N alone in the reduction of vomiting episodes, both in subgroups of patients receiving cisplatin and in those receiving other CT combinations. There was no statistically significant difference between the treatments with regard to the patients' assessments of the severity of nausea or effects on appetite. Approximately half the patients (63% with N plus DXM versus 47% with N) reported no side effects. The frequency and severity of central nervous system adverse reactions, mainly vertigo, were similar in both treatment groups. The fall in blood pressure was significantly greater after N alone. Two thirds of the patients preferred N plus DXM. Thus, the addition of DXM to N enhanced the therapeutic yield of N, and we recommend DXM as an adjunct to N, when the use of steroids is not contraindicated. The optimal dose and schedule of DXM was not investigated in our study; a higher dose of DXM might increase the clinical benefit of the drug combination tested.
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PMID:Antiemetic efficacy of nabilone and dexamethasone: a randomized study of patients with lung cancer receiving chemotherapy. 303 31

Based on the overall results of a UFT phase II study made in 104 institutions in Japan from April of 1979 to September of 1980, there was a response rate of 27.7% with 3 CR cases and 49 PR cases out of 188 stomach cancer cases considered as evaluable according to solid cancer chemotherapy direct efficacy criteria. Other response rates were spleen cancer 25%, gallbladder cancer 25%, liver cancer 19.2%, colorectal cancer 25%, breast cancer 32% and lung cancer 7%. Side effects out of 551 cases were, loss of appetite 24.3%, nausea/vomiting 12.5%, diarrhea 11.1% and other digestive system symptoms mainly. The hematologic side effects were mild, being 6.9%. According to the UFT phase II study, in 438 evaluable cases followed for 5 years after testing, the results were analyzed in terms of therapeutic efficacy and survival time. In 185 stomach cancer cases, 50% survival time was 185 days, with CR + PR cases 336 days, MR + NC cases 183 days, and PD cases 97 days. Colorectal cancer showed a 50% survival time of 227 days in 54 cases, while that for 49 breast cancer cases was 505 days. Total Ftorafur (FT) results using the same criteria from the UFT phase II study revealed, from a comparison of dosage and disease type, that UFT did not enhance FT side effects; rather, it markedly increases effectiveness. Therefore, on the basis of its response rate and the survival time for the cases of digestive system cancer, UFT is considered an effective anticancer agent.
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PMID:[Report on nationwide pooled data and cohort investigation in UFT phase II study]. 311 85

From 1977 to 1982, 62 patients with various advanced malignant solid tumors were treated by HD-MTX-CFR therapy and totally 129 courses were given. Majority of the patients suffered from malignant lymphoma (10), osteogenic sarcoma (11), lung cancer (16), esophageal cancer (3), breast cancer (3) and malignant melanoma (4). All were confirmed by cytology or pathology except one primary liver cancer. There were clinically measurable lesions in 59 patients for evaluation of the treatment, and 3 osteogenic sarcoma patients without metastasis were given a postoperative adjuvant chemotherapy. 33 out of 62 had received chemotherapy and/or radiotherapy before. Dose of MTX ranged from 2 to 3 gm per course in most patients and dose of CF, from 9 to 12 mg every 6 hours for 3 days. 2 (3.4%) patients achieved complete remission (1 osteogenic sarcoma and 1 malignant lymphoma) and 8 (13.6%), partial remission (1 osteogenic sarcoma, 5 malignant lymphoma, 1 esophageal cancer and 1 breast cancer) with a total response rate of 15.9%. No response was observed in all 16 lung cancers. The main side effects of HD-MTX-CFR therapy were leukopenia, thrombocytopenia, elevation of SGPT, nausea, vomiting, mucositis, skin rash, fever and fatigue. All patients were followed more than 3 years. 4 patients are still alive (9, 9, 4 and 7 years, respectively), including 3 osteogenic sarcoma patients who received postoperative adjuvant chemotherapy and 1 mycosis fungoides.
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PMID:[High-dose methotrexate with citrovorum factor rescue (HD-MTX-CFR) in the treatment of malignant solid tumors--clinical analysis of 62 patients]. 326 85

"Environmental tobacco smoke" (ETS) is the term used to characterize tobacco combustion products inhaled by nonsmokers in the proximity of burning tobacco. Over 3800 compounds are in tobacco smoke, many of which are known carcinogens. Most ETS exposure is from sidestream smoke emitted from the burning tip of the cigarette. Sidestream smoke is hazardous because it contains high concentrations of ammonia, benzene, nicotine, carbon monoxide, and many carcinogens. Nonsmokers chronically exposed to ETS are believed to assume health risks similar to those of a light smoker. Children of parents who smoke have more respiratory infections, more hospitalizations for bronchitis and pneumonia, and a smaller rate of increase in lung function compared to children of parents who do not smoke, particularly during the first year of life. Among adults with preexisting health conditions such as allergies, chronic lung conditions, and angina, the symptoms of these conditions are exacerbated by exposure to ETS. The acute health effects among healthy adults include headaches, nausea, and irritation of the eyes and nasal mucous membranes. The evidence for a relationship between ETS and cancer at sites other than lung is insufficient to draw any positive conclusions. For lung cancer, studies have consistently shown an excess risk between 10% and 300%, with a summary relative risk of 1.3 (95% confidence interval = 1.1-1.5). A dose-response relation is suggested but difficult to assess completely. Histologic types of lung cancer are generally similar to those most closely associated with active smoking, although other histologic types have also been found. Both excess relative risks and the dose responses are underestimates of the true excess risk and of the range of dose-response effect. Although the temporal relationship between exposure and disease occurrence is established, many questions are unanswered. The findings are consistent with many known biologic effects of active smoking and are partially analogous to the biologic effects of direct smoke inhalation. As many as 5000 nonsmokers are estimated to die annually from lung cancer as a result of exposure to ETS. There is great potential for prevention of these premature deaths. The two major preventive actions are (a) eliminating the source by reducing the amount of direct smoking and (b) limiting the level of exposure by restricting where tobacco can be smoked. Specific preventive actions include smoking cessation, smoking prevention, restriction of advertising, increased taxation on tobacco, and adoption of stringent nonsmoking policies in the workplace, schools, and public places.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Health hazards of passive smoking. 328 40

Thirty-two patients with primary lung cancer receiving combination chemotherapy including cisplatin at a dosage of 80-120 mg/m2 were entered into an antiemetic randomized crossover trial. Patients received metoclopramide (2 mg/kg i.v. every 2 h X 5), droperidol (0.5 mg/kg i.v.) and dexamethasone (30 mg i.v.) on day 1, and metoclopramide (1mg/kg i.v. every 8 h X 3) (Regimen A) or metoclopramide and droperidol (2.5 mg i.v. every 8 h X 3) (Regimen B) on days 2 to 5. No vomiting occurred within the first 24 hours after cisplatin administration in 75% of patients. Regimen B was found to be more effective than regimen A with respect to the mean duration of vomiting (p less than 0.1), the mean duration of nausea (p less than 0.05), the mean duration of anorexia (p less than 0.05), and the mean score of the patients' opinions (p less than 0.1). When the patients were asked for their opinion of the two regimens, 39% preferred regimen B (p less than 0.05). There were no major side effects with either regimen.
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PMID:[Antiemetic effects of combinations of metoclopramide, droperidol and dexamethasone for the prevention of cisplatin-induced gastro-intestinal toxicity: a randomized crossover trial]. 330 May 61

Forty patients with advanced lung cancer who had received chemotherapy containing cisplatin (80 mg/m2) were accrued for a randomized controlled trial to evaluate the additional effect of prochlorperazine on the combination of high-dose metoclopramide and dexamethasone for the treatment of acute cisplatin-induced emesis. The effect of intravenous metoclopramide and dexamethasone in emesis occurring more than 24 hours after cisplatin administration was also evaluated. Excellent emetic control (no emesis during 24 hours after cisplatin administration) was achieved in 70% (14/20) and 76% (16/21) of the patients who received the combination of prochlorperazine, metoclopramide and dexamethasone and the combination of metoclopramide and dexamethasone, respectively. The overall toxicities associated with both regimens were not serious and were similar. Patients treated with metoclopramide and dexamethasone on days 2-7 experienced less delayed emesis, nausea and anorexia compared with those treated with a placebo (delayed emesis, 25% versus 50%, respectively, p = 0.105; more than 4 days of nausea, 10% versus 35%, respectively, p = 0.059; less than 3 days of anorexia, 80% versus 50%, respectively, p = 0.048). It was concluded that metoclopramide and dexamethasone showed an excellent antiemetic effect on acute drug-induced emesis, as well as on delayed emesis, induced by cisplatin.
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PMID:[A randomized controlled trial of acute and delayed cisplatin-induced emesis with metoclopramide, dexamethasone and prochlorperazine]. 331 Sep 5

The first patient to respond to [(glycolato-0,0') diammineplatinum (II)] (254-S) in a clinical phase I study is reported. The patient was a 52-year-old man complaining of nausea and weight loss. A chest X-ray demonstrated a diffuse infiltrating shadow in the right lung. A transbronchoscopic brushing of the right upper lobe and a biopsy specimen from the right supraclavicular lymph node revealed adenocarcinoma of the lung. He was diagnosed as having primary lung cancer with distant lymph node metastasis. 254-S was administered by intravenous drip infusion to a dose of 100 mg/m2. Two weeks after the second 254-S treatment, a chest X-ray demonstrated a more than 50% reduction in the pulmonary shadow and met the WHO criteria for a partial response. Thrombocytopenia, leukocytopenia and moderate nausea were observed as adverse effects of 254-S but renal toxicity was not found. Pharmacokinetics of free platinum in this patient demonstrated biphasic decay with a peak plasma concentration of 8.09 micrograms/ml. A disease-oriented phase II study of 254-S against non-small cell lung cancer should be performed to establish the efficacy of this new platinum complex.
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PMID:A case report of pulmonary adenocarcinoma responding to (glycolato-0,0') diammineplatinum (II), a new platinum complex. 331 21

High-dose intravenous (IV) metoclopramide has shown efficacy with few side effects for the treatment of nausea and vomiting on the day of cisplatin administration. From November 1984 to January 1986, two randomized trials in an antiemetic study were conducted. In trial I, the antiemetic effect of a short course of high-dose dexamethasone was compared with that of high-dose metoclopramide in 29 patients with lung cancer receiving chemotherapy containing cisplatin (80 mg/m2 IV) in a randomized controlled trial. Dexamethasone was given IV at a dose of 16 mg 1/2 hr before and 8 mg, 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Metoclopramide was given IV at a dose of 2 mg/kg, 1/2 hr before and 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Major emetic control (0-2 episodes of vomiting) during the 24 hr after cisplatin administration was achieved in 55% (6/11) and 67% (12/18) of the patients receiving dexamethasone and metoclopramide, respectively, without serious toxicity. The duration of nausea or anorexia was similar for the two treatment groups. In trial II, the combination of metoclopramide and dexamethasone was compared with metoclopramide alone to assess the additive antiemetic effect of the two drugs in 23 patients with lung cancer receiving cisplatin at a dose of 120 mg/m2 IV in a randomized cross-over study. A major antiemetic response was observed in 27% (3/11) and 92% (11/12) of the patients receiving metoclopramide alone and metoclopramide plus dexamethasone, respectively (p less than 0.005). The duration of nausea and anorexia was similar for the two treatment groups. Patients tended to prefer the combination of metoclopramide and dexamethasone; however, the difference was not statistically significant (p = 0.14) in the small number of patients entered in this study. Despite excellent control of acute chemotherapy-induced emesis, 45% of 52 patients experienced delayed nausea and vomiting more than 24 hr after cisplatin administration even among those who had had an excellent short-term response to the antiemetic agents.
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PMID:Antiemetic efficacy of high-dose intravenous metoclopramide and dexamethasone in patients receiving cisplatin-based chemotherapy: a randomized controlled trial. 353 48

Survival in patients with locally advanced, non-small-cell lung cancer (NSCLC) is relatively short, despite treatment with surgery or radiation. A phase II study of simultaneous continuous infusion 5-fluorouracil and split-course radiation with or without surgery has shown possible improvement in median survival compared with that observed in trials of radiation alone. Past success with etoposide plus cisplatin in NSCLC has led to the addition of etoposide to the 5-fluorouracil plus cisplatin plus radiation combination. Twenty-four stage III NSCLC patients were treated with this three-drug regimen, and a 74% clinical partial remission rate was observed. Thoracotomy was done in eight of these patients; subsequent histologic examination of the resected specimen revealed no residual tumor in four patients (50%) and only microscopic foci of tumor in two patients (25%). Major toxicities were leukopenia, nausea, and vomiting. Median leukocyte nadir was 2,900/mm3. A leukocyte count less than 1,000/mm3 was observed in two of 24 patients (8%), one of whom expired from progressive pneumonia. All patients experienced nausea and vomiting, which were classified as moderate in three patients (12%) and severe in four (16%). Moderate to severe esophagitis, dermatitis, and pneumonitis were not observed. Median progression-free interval and median survival were not reached after a median follow-up of 163 days.
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PMID:Phase II trial of etoposide, cisplatin, continuous infusion 5-fluorouracil, and simultaneous split-course radiation therapy in stage III non-small-cell bronchogenic carcinoma. 376 46


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